Related Experiment Videos
[Removal of amino acids by continuous hemofiltration and hemodiafiltration]
J B Gouyon1, M Françoise, J Desgres
1Service de pédiatrie 2, hôpital d'Enfants, Dijon, France.
Background:
Continuous hemodiafiltration is potentially more efficient than hemofiltration for removing low molecular metabolites.
Case Report:
A newborn (2100 g) was admitted suffering from acute distress with statuts epilepticus, liver failure with generalized hyperaminoacidemia, hypoglycemia and oligo-anuria. Peritoneal dialysis, performed on the 17th day of life, was ineffective and the patient was treated by continuous hemofiltration alternating with hemodiafiltration. Clearance of amino-acids was studied for 15 minutes under each technique. The amino-acid concentrations were measured in the infused fluid and in the ultrafiltrate. The baby died on the 20th day despite this treatment.
Results:
Amino acid clearance by hemodiafiltration was 181 +/- 176% greater than by hemofiltration. The mean improvement for all amino acids was 148%, with extremes of +43% for citrulline and 941% for glutamic acid.
Conclusion:
Continuous hemodiafiltration is an efficient method of removing amino acids; it could be used to treat severe inborn errors of metabolism such as leucinosis.